Mindfulness Reduces Pain and Opioid Abuse

Posted on February 12th, 2014

Prescription opioid medications are commonly used in the U.S. as treatments for medically serious pain. Unfortunately, significant numbers of prescription opioid users eventually become opioid abusers or opioid addicts. According to the results of a study published in January 2014 in the Journal of Consulting and Clinical Psychology, use of a new, non-medication-based pain relief option called mindfulness-oriented recovery enhancement (MORE), could potentially substantially diminish the need for opioid painkillers. In turn, a reduction in opioid painkiller use could help reduce the rates for both opioid abuse and opioid addiction.

The Basics

Prescription opioids are used to address pain in a range of medical settings and circumstances, including dental procedures, chronic pain associated with long-term ailments or diseases, and short-term pain associated with the aftermath of injuries or surgeries. Some of the most commonly prescribed opioid medications in the U.S. are hydrocodone (Vicodin, Polygesic, Hydrocet), oxycodone (OxyContin, Endocodone, Percocet), codeine, morphine and fentanyl (Fentora, Abstral). Opioid abuse occurs when a prescription user takes too much of a medication at one time or takes a medication more often than directed. People without a proper prescription abuse opioids whenever they take an opioid medication, either for pain relief or for recreational purposes. Habitual opioid abusers can eventually develop an opioid addiction, which includes chemical dependence on the effects of opioids, the presence of certain classic drug-seeking behaviors and the adoption of a drug-oriented lifestyle.

MORE Basics

Mindfulness-oriented recovery enhancement (MORE) was created specifically to help people dealing with alcoholism; it has now been adapted to help people with chronic pain issues who have significant chances of abusing opioid medications. MORE uses a three-pronged approach to address the effects of significant pain without relying on the painkilling effects of opioids or other medications. The first element of the approach is mindfulness training that increases a patient’s ability to pay attention, stay focused on his or her immediate surroundings and gain awareness of his or her habitual behaviors. The second element, called reappraisal, helps a patient learn to see unpleasant or stressful situations as opportunities for self-enrichment or personal growth. The third element, called savoring, helps a patient learn to center his or her attention on rewarding situations that produce feelings of well-being or connectedness with others. These overlapping skill sets are typically practiced over the course of 10 sessions.

Effectiveness

In the study published in the Journal of Consulting and Clinical Psychology, researchers from the University of Utah assessed the effectiveness of mindfulness-oriented recovery enhancement as a treatment for chronic pain patients currently abusing prescription opioids or at risk for developing problems with opioid abuse. These researchers gathered data from 115 individuals affected by chronic pain. Half of these individuals received an eight-week course of MORE, while the other half participated in support groups designed to help people affected by serious pain-related issues. Prior to starting the study, almost 75 percent of the people in both treatment groups abused their pain-relieving opioid medications in one way or another. The researchers compared this level of involvement in opioid abuse to the level found in each of the groups immediately following treatment, as well as three months after treatment came to an end.

After completing their comparisons, the researchers concluded that nearly two-thirds (63 percent) of the participants who received training in mindfulness-oriented recovery enhancement substantially reduced their level of involvement in prescription opioid abuse. In contrast, only one-third (32 percent) of the participants who attended support group meetings for chronic pain substantially reduced their involvement with prescription opioid abuse. The reduced involvement in opioid abuse in the MORE group appears to be directly related to the approach’s ability to improve pain symptoms; all told, the participants in this group experienced a roughly 22 percent decrease in the severity of their symptoms. This pain relief still remained in effect at the end of the three-month follow-up period.

Significance and Considerations

The authors of the study published in the Journal of Consulting and Clinical Psychology believe that the effectiveness of MORE comes from the deep-seated connection between the human brain and the human body, which allows changes in mental outlook to trigger substantial changes in physical responsiveness and well-being. They are currently preparing for larger-scale studies focused on the use of mindfulness-oriented recovery enhancement in both general and military populations. They are also investigating the potential usefulness of MORE for people simultaneously affected by substance abuse/addiction and mental illness. In the future, doctors may begin to adopt the MORE approach as part of a larger overall approach to dealing with chronic pain.

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